Transitions of Care

Transitions of care, sometimes called patient handoffs, are a crucial. When executed well, patients avoid adverse complications and benefit from improved health outcomes. The Joint Commission estimates that 80% of serious medical errors occur when patients are transferred – either between facilities or between providers at the same facility. The risk of re-hospitalization, or worse, is high. Because patients are at their most vulnerable during this transition, it’s even more important that providers on both ends of the transition are communicating effectively.

Health Information Exchange Improves Transitions of Care

CORHIO operates a statewide health information exchange (HIE) that long-term and post-acute care providers use to improve transitions of care with providers outside of their organization. The HIE gives providers instant access to vital patient information, such as lab results and treatment plans through the web-based portal PatientCare 360. From this HIPAA secure portal, providers can see real-time details on the tests and treatments a patient recently had. This information can also be pulled in to care summary documents that can accompany the patient during the care transition, either electronically or on paper.

Direct Messaging Allows for Care Summary Exchange

Care summaries, or continuity of care documents (CCDs), created in CORHIO’s PatientCare 360 system can be sent back and forth between providers using Direct messaging or the CORHIO e-Referrals tool (coming soon). CCDs allow for accurate and timely information sharing so all providers are on the same page in regard to a specific patient.

Direct messaging is a way of securely exchanging email-like messages, in order to meet HIPAA regulations and protect health information. Learn more about Direct messaging.

What our participants are saying:

“The biggest challenges we had when somebody was discharged from a hospital was getting accurate and up-to-date information. Often times, clients are discharged with a new diagnosis or a medication that they don’t fully understand so getting that information in a timely manner and educating our clients was very difficult. Now with HIE, it makes it much simpler to have all of the information in one place and you know that the information is accurate because it comes straight from the hospital.”

Alexis Bellinger, RN
Home Health Nurse
Professional Home Health